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NPI Code Detail

MEDICARE: MR. ROBERT JOHN KRETLOW

MEDICARE: MR. ROBERT JOHN KRETLOW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant0663NC

General Provider Information

NPI Number : 1861696924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT JOHN KRETLOW
Provider Business Mailing Address
First Line : 1002 PEMBROKE RD
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-6716
Country : US
Telephone Number : 336-299-8859
Fax Number :
Provider Business Practice Location Address
First Line : 206 GREENSBORO RD
Second Line :
City : HIGH POINT
State : NC
Zip : 27260-3456
Country : US
Telephone Number : 336-882-2164
Fax Number : 336-882-2164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ MR. ROBERT JOHN KRETLOW ” Practice Location

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